What You Need To Know About Adenomyosis

Most women are familiar with endometriosis, a common and often painful disorder in which the cells that are normally contained within the uterus find their way out and attach themselves to your other organs. The endometrial cells can often be found growing on the ovaries, bowel, or attached to the lining of the pelvis.

But there is another condition that is rarely spoken of called adenomyosis. This condition keeps the endometrial cells confined to the uterine muscle but they migrate to the back wall of the uterus. They are then trapped in the myometrium, which is the smooth middle layer of the uterine muscle. The myometrium's normal function is to stimulate uterine contractions.

With the help of the monthly hormonal changes a woman goes through, the myometrium can become trapped with blood, resulting in a large and often hard uterus. This results in the following common symptoms:

Painful periods

Extremely heavy periods

Extended bleeding cycles beyond the normal 3 to 7-day cycle

Massive clots

Abdominal bloating

Back pain

Severe abdominal cramping that can be as severe as labor pains, even when you aren't bleeding

Nausea and vomiting

Anemia

An official diagnosis is difficult to obtain, and the diagnosis is often given when a woman presents with the above symptoms. As ultrasound machines become better and better technologically, a definitive diagnosis via a transvaginal ultrasound is becoming easier, particularly if performed when the patient is actively bleeding. A D&C (dilation and curettage) in which a biopsy is taken of the uterine lining via the cervix, can also positively confirm an adenomyosis diagnosis.

Who Gets Adenomyosis?

Adenomyosis most often shows up in perimenopausal women in their early to mid-forties who have had children. A hormonal imbalance, usually with too much estrogen, is another common indicator. Studies are being done to see if there may be a genetic factor at play, but there is nothing definitive yet as to the cause.

How Is Adenomyosis Treated?

Adenomyosis is a benign, chronic condition. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDS) along with the use of a heating pad are usually the first recommendation. Correcting the hormone balance can be useful. This is now usually done by implanting an intrauterine device (IUD) such as Mirena, which uses levonorgestrel, a progestin hormone, and does not contain estrogen, which would worsen the condition. The IUD typically slows the bleeding considerably, but it can take several months to stop it completely. Unfortunately, it may not work for severe cases. The only cure for adenomyosis is a hysterectomy, which many women eventually opt for as this condition can be quite disabling.

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